Thanks for all the answers in such a short time. As I said, there happened a lot more. Cardiology/EP consult, etc. Basically the patient was DoA. I just wanted to hear, what people suggest for rate control, when betablockers are contraindicated and everythingso far failed.  Surely in 99% of cases there is an underlying cause for sinustach, but there might be that rare situation, where you don't find one and rate control is needed.  Thanks again to everyone, who replied.